DOI: 10.1177/1098612x231215639 ISSN: 1098-612X

Recasting the gold standard – part II of II: communicating healthcare options along a continuum of care

Ryane E Englar
  • Small Animals

Series outline

This is the second part of a two-part series on spectrum of care that encourages practitioners to tailor case management to the patient along a continuum of acceptable options. Part I defined the spectrum of care and broadened its approach beyond initial cost-of-care considerations. This second article introduces strategies for initiating conversations with clients about their needs, wants and expectations specific to healthcare options and case management decisions. It will explore how open inquiry, reflective listening, transparency and unconditional positive regard facilitate dialogue between providers and their clients as they collaborate on decision-making along a spectrum of care.


Contextual case management prioritizes interventions that are appropriate for both the patient and the client. To identify and explore which healthcare options represent the best fit for those impacted most by medical decisions, veterinarians need to make space for clients to feel comfortable sharing their perspectives. Clients are more likely to be engaged in decision-making when their insight is actively solicited. They have much to share with us as experts about their cat’s overall health and wellness needs. Inviting clients to contribute to the consultation and being receptive to hearing what motivates their choices helps us to structure conversations around healthcare options. The ability to communicate healthcare options is as vital as the provision of healthcare, if not more so.

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